ES2758925T3 - Endodontic treatment apparatus and system - Google Patents

Abstract

An endodontic treatment apparatus comprising a nozzle (401, 603, 701, 901, 1219) comprising a tip small enough to be inserted through the pulp chamber of a tooth; wherein said nozzle is shaped to create a beam comprising at least one jet of fluid at an angle to a vertical axis of said nozzle; and comprising one or more inlet pipes (605) that are configured to be connectable to external sources (801, 803, 813) of components so that a fluid is emitted from the nozzle; characterized in that said nozzle comprises: an internal cone (411, 417, 441, 613, 703) and an external cone (413, 615, 705) that defines a light (709) between them for the fluid to flow; wherein said light (417, 709) is configured such that the fluid supplied by said one or more inlet pipes travels through the light (417, 709) along a helical path that has a tangential and longitudinal component ; and wherein said angle of said at least one jet of fluid does not intersect said vertical axis of said nozzle.

Description

DESCRIPTION

Endodontic treatment apparatus and system

Field and background of the invention

The present invention, in some embodiments thereof, relates to an apparatus for endodontic treatment and, more particularly, but not exclusively, to an apparatus and to treat a root canal using one or more angled fluid jets.

In cases where a tooth is decayed, infected, or abscessed, a root canal procedure can be performed to clear the infection and decontaminate the tooth. During the root canal procedure, substances such as nerve tissue and pulp are removed to prevent future infections.

Current methods of treating a root canal may involve the use of files, such as metal files, to remove tissue such as nerve tissue, magma, pulp tissue, or blood vessels from the root canal. In some cases, a rotary file drill is used to shape a root canal and, optionally, widen a portion of it to allow access. One of the risks of using files for endodontic treatment is the spread of a smear layer, which may include organic and / or inorganic debris, on the root canal wall after instrumentation. Another potential risk of file use may include wounds to the root canal wall or the apex.

Endodontic treatment devices have been disclosed by various publications.

United States Patent Publication Number 6224378 to Valdes et al. describes "A method and apparatus for dental procedures using a dental water jet tool having a cannula extending therefrom. The cannula is connected to a high pressure liquid source and supplies a high speed high pressure jet For endodontic procedures, the cannula is directed through an opening formed in the crown of the tooth, and the jet of water is directed at the pulp, nerve, and vascular tissue within the inner chamber. " Detaille United States Patent Publication No. 4021921 discloses "a device for treating the pulp canals and the pulp chamber of a tooth, the crown of which has a previously opened pulp chamber in which the canals are opened, comprising a strongly adaptable to the crown of the tooth and providing the pulp chamber and pulp ducts of said tooth with the circulation of a treatment solution that acts substantially on the vascular nerve bundle or the necrotic magma of the tooth; the pressure of the treatment solution is subjected within the pulp chamber and pulsed ducts with periodic pulses combined with oscillations of substantially higher frequency. "

Summary of the invention

The present invention is an apparatus for endodontic treatment according to claim 1. Preferred embodiments are defined in the dependent claims.

In accordance with one aspect of some embodiments of the present invention, an apparatus for endodontic treatment is provided.

In accordance with one aspect of some embodiments of the present invention, an endodontic treatment apparatus is provided comprising a nozzle, the nozzle comprises a tip small enough to be inserted through the pulp chamber of a tooth, the nozzle is shaped to creating a bundle comprising at least one stream of fluid angled with respect to a vertical axis of the nozzle, so that it flows along a wall of the root canal to remove soft tissue, and the nozzle is connected to a entry. According to some embodiments, the nozzle comprises an inner cone and an outer cone that defines a light therebetween for fluid to flow. According to some embodiments, the nozzle comprises a tube that extends between a lumen of the inner cone and the lumen between the inner cone and the outer cone. In accordance with some embodiments, the fluid circulates in a helical flow through the lumen to exit the nozzle at an angle. In accordance with some embodiments, the angled stream of fluid does not intersect a vertical axis of the nozzle. In accordance with some embodiments, the nozzle comprises ducts to create at least one angled stream. In accordance with some embodiments, a system is provided comprising: the apparatus, a liquid tank, and an air compressor, wherein the apparatus inlet piping passes through a handle to connect the liquid tank and / or the air compressor to the nozzle. In accordance with some embodiments, the system is electrically controlled through the use of a control panel and an electrical circuit. According to some embodiments, the fluid comprises abrasive gas and / or liquid and / or powder. According to some embodiments, the gas is air and the fluid comprises between 50-95% air and between 5-50% liquid. According to some embodiments, the nozzle is shaped so that the fluid leaves the nozzle as an aerosol. According to some embodiments, the apparatus is connected to an air compressor with a pressure ranging from 5-200 PSI. In accordance with some embodiments, the apparatus is connected to a fluid tank that provides fluid at a volume flow rate ranging from 0.1-50 ml / s. In accordance with some embodiments, the angled stream has components of tangential and vertical velocity with respect to the root canal wall. In accordance with some embodiments, the apparatus comprises a suction cone to collect fluid and return debris, and the suction cone has a tip sized to fit within the pulp chamber of a tooth.

An example of the use of some embodiments of the present invention is a method, not part of the present invention, for endodontic treatment comprising directing at least one jet of fluid at an angle that causes it to flow along a wall of a root canal for flow to remove material from the root canal wall. In accordance with some embodiments, removal comprises separating the soft tissue from the wall of the root canal. According to some embodiments, the flow comprises a helical flow along the wall of the root canal. According to some embodiments, the root canal comprises at least one narrowing portion, and the flow comprises flowing through the narrowing portion along the wall of the root canal. According to some embodiments, the root canal comprises a bend and / or a branch, and the flow comprises flowing through the bend and / or branch. In accordance with some embodiments, the method comprises placing a nozzle over an inlet to the root canal so that at least one jet of fluid at an angle impacts a wall of the root canal. In accordance with some embodiments, fluid flows along the wall of at least a portion of the root canal, so that fluid returns upward along at least a portion of the central lumen of the root canal. In accordance with some embodiments, the method comprises eroding a layer of dentin tissue from at least a portion of the root canal wall. According to some embodiments, the layer has a thickness that varies between 100-200 | jm. In accordance with some embodiments, the angled jet is created by circulating the fluid in a helical flow within a nozzle of an apparatus. In accordance with some embodiments, the soft tissue comprises nerve tissue and / or pulp tissue and / or blood vessels. According to some embodiments, the method does not leave a smear layer on the root canal wall. According to some embodiments, directing comprises directing the fluid jets in pulses. In accordance with some embodiments, directing includes cleaning a root canal to prepare for sealing.

Brief description of the drawings

Some embodiments of the invention are described herein, by way of example only, with reference to the accompanying drawings. In the following, with specific and detailed reference to the drawings, it is emphasized that the particularities shown are by way of example and are intended to illustratively describe the embodiments of the invention. In this sense, the description, together with the drawings, makes it apparent to those skilled in the art how the embodiments of the invention can be practiced.

In the drawings:

FIG. 1 is a flow chart of an example endodontic treatment procedure;

Figure 2 is a flow diagram of an example method for cleaning and / or eroding a root canal using one or more angled fluid jets;

Fig. 3 is an illustration of angled fluid jets entering a root canal and advancing along the root canal wall in a helical flow, illustrating the exemplary use of an apparatus in accordance with some embodiments of the invention. ;

Figures 4A-4C are illustrations of a conical nozzle positioned at an entrance to a root canal, in accordance with some embodiments of the invention;

Fig. 5 is a side view of various contours of a beam of angled fluid jets exiting a nozzle, in accordance with some embodiments of the invention;

Figures 6A-B are a cross section and a schematic view of an apparatus comprising a handle and a conical nozzle, in accordance with some embodiments of the invention;

Figures 7A-7B are a cross section of a conical nozzle and a side view of an internal cone configured within the conical nozzle, in accordance with some embodiments of the invention;

Figures 8A-8B are schematic diagrams of example systems for treating a root canal, in accordance with some embodiments of the invention;

Figures 9A-9D are illustrations of a conical nozzle comprising a pipeline extending between a handle and a nozzle outlet opening, in accordance with some embodiments of the invention;

Figures 10A-10B are illustrations of a nozzle comprising a suction cone and a horizontal cross section of the nozzle, respectively.

Figures 11A-11B are illustrations of a nozzle including one or more steering lines to create one or more angled fluid jets, in accordance with some embodiments of the invention;

Figures 12A-12C are illustrations of a nozzle comprising a valve to control flow through the nozzle, in accordance with some embodiments of the invention;

Figures 13A-13D are illustrations of a nozzle comprising a cone and a pin-shaped element occupying at least a part of the internal lumen of the cone, according to some embodiments of the invention; Figure 14 shows an example assembly of a nozzle, in accordance with some embodiments of the invention. Fig. 15 is an illustration of a nozzle including outlet flow shaping elements for creating one or more angled fluid jets, in accordance with some embodiments of the invention; and

Figures 16A-B is a table of experimental results of an experiment to test the feasibility of an apparatus for endodontic treatment, according to some embodiments of the invention.

Figure 17 is an image of a layer of dentin and dentinal tubules taken by an electric scanning microscope after treating a root canal using the apparatus.

Description of specific embodiments of the invention

The present invention, in some embodiments thereof, relates to an apparatus for endodontic treatment and, more particularly, but not exclusively, to an apparatus for treating a root canal using one or more angled fluid jets.

In some embodiments, the appliance is used to clean, erode, and / or decontaminate the root canal of a tooth prior to sealing the tooth.

An aspect of some embodiments of the invention relates to cleaning and / or erosion of a root canal using one or more sloped fluid jets. In some embodiments, once the angled stream hits the root canal wall, the force exerted by the wall channels the stream to travel down the root along the wall. In some embodiments, the angle includes an out-of-plane component of the root canal axis, so that the flow rotates in a helical flow along all or part of the root canal. In some embodiments, the fluid advances along the root canal wall to remove the organic substance and / or erode the canal wall. In some embodiments, the angled fluid stream does not cross a vertical axis of the root canal and / or a vertical axis of the nozzle.

In some embodiments, the passage of flow through the conduit is facilitated by the fluid advancing along the wall. In some embodiments, the fluid flow passes through a narrowing portion of the root canal to clean and / or wear the narrow and / or distal section of the root canal. In some embodiments, the fluid flow continues to the apex of the root canal. In some embodiments, at least some of the fluid flows upward through the root canal, flushing soft tissues such as nerve tissue, blood vessels, magma, and / or debris. In some embodiments, as fluid flow progresses along the wall of the conduit, the returning fluid passes upward through the center of the conduit. Optionally, the resulting flow path allows continuous irrigation to clean and / or erode the root canal. Optionally, irrigation is performed periodically to allow fluid to exit the conduit. In some embodiments, a volumetric flow rate of fluid passing through the root canal varies between 0.5-50 ml / second, for example, between 1-9 ml / second, 30-40 ml / second.

In an exemplary embodiment of the invention, flow travels along the root canal wall for at least 20%, 50%, 70%, 90%, or intermediate or greater percentages of the root canal length. In some cases, part of the flow, for example at the distal end of the conduit, includes significant turbulent flow (for example, away and towards the wall).

In some embodiments, the direction and / or magnitude of the momentum of fluid exiting a nozzle of the apparatus is determined by the structure of the nozzle. In an exemplary embodiment, the fluid circulates in a lumen formed between two cones within the nozzle so that it exits the nozzle at an angle to a vertical axis of the nozzle. In another embodiment, passing the fluid into a structural element of the nozzle, such as an inclined tube configured in a plane that crosses the vertical plane of the tooth, can create the angled direction of the jets.

One aspect of some embodiments of the invention relates to a rapid flow of fluid that passes through the root canal and optionally is introduced into at least a portion of the dentinal tubules. In some embodiments, a ratio of gas (such as air) to liquid (such as water, disinfectant, antiseptic medication, and / or any other solution) is used. In one example, a fluid can comprise 90% air and 10% liquid. In some embodiments, the selected ratio can affect parameters such as fluid elasticity, fluid velocity, and / or flow rate. Optionally, fluid components, such as air bubbles, can facilitate removal of the organic substance from the duct wall.

In some embodiments, a relatively low jet source pressure or jet stream exiting a nozzle is used, for example between 10-200 PSI. In some embodiments, the angle jet pressure upon impact with a root canal wall is lower, for example, between 5-150 PSI.

In some embodiments, the rapid flow of fluid erodes a layer of tissue, eg, dental tissue. Optionally, erosion is accomplished by adding abrasive particles to the fluid, which are then pushed against the canal walls, dragging a layer of dentin tissue, magma, debris, and / or bacteria. In some embodiments, erosion of at least 50-80%, 20-30%, 80-90% of a root canal wall surface is performed. In some embodiments, the fluid flow smooths the wall of the root canal.

In some embodiments, the root canal wall is subjected to shear forces exerted by fluid flow. Optionally, a thin layer of tissue is removed due to the applied force. In some embodiments, turbulent flow can be observed in at least a portion of the root canal, for example, near the apex. Optionally, a turbulent flow can increase the shear forces exerted by the fluid flow.

In some embodiments, various parameters of the apparatus and / or system can be selected, such as the angle of the fluid jet, the ratio of gas to liquid, the type of abrasive powder and / or any other parameter or combination thereof to optimize the effectiveness of the device and / or system.

In an exemplary embodiment of the invention, a plurality of jets are used. Optionally, the use of a plurality of jets allows more freedom (for example, less manual precision and / or allows coincidence with various geometries) in the orientation of the nozzle, since at least one jet is more likely to have a necessary angle for the proper treatment of the root canal. Optionally or as an alternative, the use of multiple jets can help to ensure that the entire wall of the root canal is hit by fluid flow at a sufficient speed and / or other parameters.

In some embodiments, the jets will be contiguous with each other, eg, in the form of a cone and / or a segment thereof.

Before explaining at least one embodiment of the invention in detail, it should be understood that the invention is not necessarily limited in its application to the details of construction and arrangement of the components and / or methods set forth in the following description and / or illustrated in the drawings and / or examples. The invention is capable of other embodiments or of being practiced or carried out in various ways.

Next, with reference to the drawings, Figure 1 is a flow chart of an endodontic treatment procedure. Figure 1 is provided for contextual information and the material is not claimed.

In some cases, for example, if a tooth is decayed, infected, and / or cracked, a dentist may decide to perform an endodontic procedure, as described in 101.

Usually, the number of root canals in a tooth depends on the number of roots of the tooth, for example, between 1-5.

In some embodiments, a root canal procedure includes removal of pulp tissue (pulpectomy), magma, nerve tissue, and / or blood vessels from the pulp chamber and root canal to prevent future infections and / or an abscessed tooth. In some embodiments, the root canal procedure includes shaping the root canal. In some embodiments, the root canal procedure includes decontamination of the tooth. A feature of some embodiments includes not performing one or more of the above, eg, not performing root canal shaping.

In an exemplary embodiment of the invention, for example, as will be described below, the root canal is cleaned without leaving a smear layer that, for example, would otherwise block the tubules and / or serve as a substrate for infection.

Before and / or during the procedure, imaging of the tooth can be performed, as described in 103. For example, X-ray images can be performed to determine the shape (or number) of root canals and / or detect signs of infection.

At 105, an access cavity to the pulp chamber and root canal is created through the crown of the tooth, for example, using a dental drill. Once the access cavity is created, the entrance to the root canal is exposed, as described in 107, optionally using a root canal file inserted through the access cavity in the pulp chamber. In some embodiments, access is provided through one side of the tooth. This may be possible if files are not used in the root canal, for example, as described below.

At this stage, to clean, shape, and / or decontaminate the root canal through the exposed inlet, a distal tip of the appliance, optionally including a nozzle as described below, is inserted through the pulp chamber, as described in 109, and a nozzle outlet opening is placed above the inlet exposed to the root canal, as described in 111. Optionally, the nozzle outlet opening is placed within the root canal, as will be further described ahead. Optionally, the nozzle outlet opening is positioned at an angle to the root canal inlet. At 113, one or more angled fluid jets discharged from the nozzle outlet opening pass through the root canal, as will be explained in the figure below. In some embodiments, as the fluid flow progresses along the root canal wall, it removes the tissue. In some embodiments, fluid flow removes organic substances such as pulp tissue, nerve tissue, blood vessels, magma, and / or debris from the root canal. In some embodiments, the fluid flow erodes a thin layer of dentin tissue from the root canal wall. In some embodiments, the fluid flow smooths the wall of the root canal. In some embodiments, the fluid flow disinfects the root canal.

In some cases, manual cleaning (eg, using a file or other methods known in the art) is used to remove some or all of the bulk debris from a conduit before using fluid jets as described herein. Optionally, liquid jets are used to remove a smear layer created by manual cleaning.

At 115, the dentist can optionally evaluate the effectiveness of the cleaning and / or erosion procedure, for example, by inserting a file to reach the apex of the root canal and detect traces of infected tissue. Optionally, a dentist may rewash and / or dry and / or disinfect the root canal (116).

In this phase, the sealing of the root canal (and / or the pulp chamber) is optionally performed (117). Optionally, sealing includes filling a hollow interior of the root canal. In some embodiments, a rubber compound can be used as the gutta-percha material to seal the root canal. Optionally, the gutta-percha material is softened and injected into the root canal, where it is then hardened. Alternatively, a more solid form of gutta-percha, eg cone-shaped, is inserted into the root canal to fill it. In some embodiments, the sealing process begins by inserting the filling material into the apex of the root canal and then progressing upward. In some embodiments, a temporary filler is used, which is then replaced by a permanent filler.

In various acts described above, techniques known in the art can be used. The acts described in 109-113 desirably use an embodiment of an apparatus of the invention to clean and / or erode a root canal, for example, as described below.

Optionally, the procedure described in 101-117 is repeated for one or more additional root canals, for example, an additional root canal of the same tooth and / or a root canal of a different tooth. Optionally, the sealing is performed for one or more root canals that were treated.

Figure 2 is a flow diagram of an example method for cleaning and / or eroding a root canal using one or more angled fluid jets. Figure 2 is provided for contextual information and the material is not claimed.

At 201, one or more angled jets of fluid are directed into a root canal to clean and / or erode it.

In some embodiments, a jet is a directed fluid flow, optionally leaving an outlet opening of a nozzle. Different embodiments may have jets with different shapes and / or conformations. For example, the jet may have a narrow beam shape. In some embodiments, a beam of a plurality of jets is used. In some cases, the stream is thin and flat and can spread angularly. In other embodiments, a jet is substantially pencil-like, but spreads on contact with the root canal wall. In an exemplary embodiment of the invention, the shape of the jet is a property of the nozzle used. In some embodiments, the shape of the jet may depend on fluid parameters, such as air / liquid ration and / or pressure and / or pulsatility. In other embodiments, the nozzle can selectively provide one of several jet forms.

In some embodiments, each of a plurality of angled jets strikes the root canal wall at a different angle so that the plurality of jets is piped to flow together along the root canal wall in a helical pattern, as will describe later.

In some embodiments, one or more jets are directed into the root canal. In some embodiments, at least a portion of a single stream or a plurality of streams impacts the wall of the root canal. In some embodiments, the force exerted by the wall channels the jets to advance along the wall of the root canal. In some embodiments, the fluid flows in a helical flow pattern along the walls of the root canal, for example, as will be described later in the figure below.

In some embodiments, as will be explained later, the one or more jets are discharged from a nozzle so that they are at an angle to a vertical axis of the nozzle. In some embodiments, the one or more jets are introduced into the root canal so that they are at an angle to a vertical axis of the root canal. Optionally, the vertical axis of the nozzle joins the vertical axis of the root canal.

In some embodiments, the bypass of one or more jets at a specific angle and / or direction is created by a designated internal nozzle structure, for example, as will be further explained below.

In some embodiments, a plurality of angled jets such as 2, 4, 8, 12, 50, 1000, or any intermediate or higher number are used. A potential advantage of using a plurality of jets may include homogeneous cleaning and / or erosion of the duct wall. Another potential advantage of using a plurality of jets includes the ability to select an angle of impact, for example, an angle of 30 °, 45 °, 70 ° between the angled jet and the root canal wall, and additional and / or alternatively to ensure that at least some of the beam jets impact the root canal wall.

In some embodiments, a single jet can be used at an angle, for example, being narrow enough to effectively advance along the duct wall, creating a thin layer of fluid in the form of a coating. Optionally, in the phenomena described above, the angled jets advance along of the conduit wall, optionally allowing some or all of the return fluid to flow back through a central lumen along the vertical axis of the conduit, as shown in the figure below. For example, 60-80%, 40-50%, 80-95% of the liquid can flow back through the central lumen, and 10-30%, 5-8%, 30-40%, can flow upward along the wall of the duct.

In some embodiments, as described in 203, the flow of fluid through the root canal removes soft tissue, such as pulp tissue, magma, nerve tissue, and / or blood vessels. In some cases, the removed tissue is infected tissue. In some embodiments, the liquid flow removes the organic substance and / or residues.

In some embodiments, the fluid flow erodes a tissue layer, eg, a thin layer, such as a thin layer of dentin tissue. Optionally, the liquid flow causes the duct to widen. In some embodiment, the liquid flow smooths the surface of the root canal wall. For example, the thickness of the eroded layer can vary between 100-200 pm, 10-70 pm, 200-300 pm. Optionally, the thickness of the eroded layer and / or the amount of debris removed by the flow depends on various parameters, such as application time.

In some embodiments, the fluid comprises liquid, such as water and / or antibacterial liquid. Additionally and / or alternatively, the fluid comprises gas, such as air. Optionally, the air / liquid mixture dispersed through the nozzle is an aerosol. Optionally, the pressure of the spray coming out of a nozzle varies between 10-200 PSI.

In some embodiments, an air-to-liquid ratio is selected as needed, for example, an air-to-liquid ratio can affect the velocity of the fluid flowing through the conduit. In an example embodiment, the fluid comprises between 60-90% air and between 10-40% liquid. In another example, the ratio of air to liquid is 90% liquid and 10% air. In another example, the fluid comprises 100% liquid.

In some embodiments, tissue erosion is accomplished by adding abrasive particles such as an abrasive powder to the fluid. Optionally, the abrasive powder comprises between 0.01-3%, 2-2.5%, 0.8-1.2% of the fluid. Some examples of abrasive powder that can be added to the air-liquid mixture include crystallite, silicon powder, garnet powder, aluminum powder, magnesium powder, ceramic powder, plastic powder, synthetic, grinding powder, powder of seashell, cement powder, salt, ground seeds and / or combinations of the above. In some embodiments, the powder grains can have a diameter ranging from 2-500 pm, 10-50 pm, 3-6 pm. In some embodiments, the powder grains can be selected according to the type of tissue to be removed. In some embodiments, air bubbles can act as an abrasive substance, for example, to erode tissue.

In some embodiments, the fluid flow disinfects the root canal, as described in 205, for example, by adding disinfectant to the fluid. Optionally, an antibacterial substance and / or medications are added. In one example, sodium hypochlorite is added to the liquid that is passed through the root canal, optionally, followed by saline and hydrogen peroxide, to disinfect the root canal. In some embodiments, there are three sources of fluids that can be used, such as water, disinfectant, and medications. Optionally, the fluid comprises one or more of these liquids.

In some embodiments, the duration of the process of removing the organic substance, eroding the tissue and / or disinfecting the interior of the root canal varies between 15-45 seconds, for example, 20 seconds, 27 seconds, 43 seconds. In some embodiments, for example, if the root canal has an extremely narrow portion, the duration of the above process can range from 45-60 seconds, for example, 50 seconds, 55 seconds. Optionally, shorter, intermediate and / or longer time periods are required to complete the process. In some embodiments, treatment is provided in periodic pulses, for example, a duration of 10 seconds followed by an interval of 10 seconds, or a duration of 2 seconds followed by an interval of 5 seconds, or any other combination. In some embodiments, during the access interval, fluid is collected from the root canal, for example, by suction.

Figure 3 shows angled jets of fluid entering a root canal and advancing along the root canal wall in a helical flow, illustrating the exemplary use of an apparatus according to some embodiments of the invention.

In some embodiments, the angled fluid jet 301 impacts the wall 303 of root canal 305. In some embodiments, the plane in which the angled fluid jet passes before and / or during root entry crosses a plane vertical of the tooth, for example, a plane in which the vertical axis passes and, as will be explained.

In some embodiments, an angle y is formed between the jet 301 and an axis extending longitudinally along the wall of the duct 303, such as axis AA. In some embodiments, for example, if a portion of the root canal is cylinder shaped, axis Aa may be parallel to vertical axis y. In some embodiments, angle y is an acute angle, for example, between 10-85 degrees, for example, 20 degrees, 45 degrees, 73 degrees. In some embodiments, the angle y is zero.

In some embodiments, an angle jet 301 or a plurality of angle jets impact the root canal wall. In some embodiments, the jets advance along the wall of the root canal. In some embodiments, once the jets impact the root canal wall, the force exerted by the wall channels the jets to rotate in a helical flow 313 through the root canal. Optionally, other forms of flow are formed, such as longitudinal streamlines along the wall of the root canal.

In some embodiments, flow 313 advances along a portion 315 of the root canal. In some embodiments, portion 315 is cylindrical. In some embodiments, flow 313 passes through a narrowing portion 317 of the root canal. In some embodiments, flow 313 passes through a narrowing portion and then through an expanding portion. In some embodiments, flow 313 passes through curve 323.

In some embodiments, the tapering portion 317 includes a portion having a diameter of less than 0.1mm, less than 0.05mm and / or intermediate or lesser values. In some embodiments, curve 323 has a radius of curvature of less than 0.05mm, less than 0.08mm, and / or intermediate or smaller numbers. In some embodiments, a length of a root canal bend and / or a narrowing whereby fluid flows through intervals, for example, between 0.1-4 mm, for example, 1 mm, 0.5 mm, 2 mm.

In some embodiments, flow 313 reaches apex 319 of the root canal. In some embodiments, flow 313 passes through the branches of the root canal, for example, reaching at least a portion of branched dentinal tubules, (not shown in this figure). In some embodiments, for example, if the anatomy of root canal 305 is unusual, such as an L or C-shaped root canal, and / or if root canal 305 has an extremely narrow portion, flow 313 can pass and clean at least most of the duct. A potential advantage of cleaning and / or eroding the root canal using fluid flow includes the ability to reach places such as bends, narrowings, and / or branches of the root canal that would otherwise have been impossible or difficult to reach, for example, when using a file.

In some embodiments, the root canal wall 303 is subjected to shear forces, which can be applied by flow 313. Optionally, due to shear forces, the flow removes a thin layer of tissue, such as dentin tissue. In some embodiments, the removal of the tissue is homogeneous. In some cases, for example, in a narrow and / or curved portion of the root canal, removal is not homogeneous. In some embodiments, homogeneous removal is dependent on root canal diameter 305. For example, in a narrowing less than 0.1 mm in diameter, removal may not be homogeneous. Optionally, in that case, a file can be used to expand the taper. In some embodiments, the thickness of the dentin layer removed by the liquid flow varies between 10-300 pm, for example, 50 pm, 80 pm, 12 pm. Optionally, intermediate and / or lower thickness layers are removed. In some embodiments, the shear viscosity of the fluid affects the thickness of the removed layer.

In some embodiments, a removal rate is controlled, for example, by applying shorter pulses, for example, to avoid punctures. In some embodiments, images can be made, for example, during treatment, to decide if additional cleaning and / or abrasion is needed.

In some embodiments, flow 313 reaches apex 319 of the root canal. In some embodiments, flow 313 may become turbulent along some portions of the root canal, for example, in proximity to apex 319.

In some embodiments, flow 313 erodes apex 319, optionally resulting in a more opaque root canal. In some embodiments, flow 313 is applied so that it does not expand a natural apex opening, for example ranging from 0.3-0.5mm, 0.1-0.2mm, 0.4-0.5mm . Optionally, the duration of treatment is selected so as to avoid penetration of at least part of the flow through the apex.

In some embodiments, at least a portion of flow 313, optionally, including the organic substance and / or debris removed, rises back up the line. Optionally, the flow passes along path 321, for example, in a central lumen along the vertical axis y. A potential advantage of the forward and return flow path may include the ability to use a large volume of fluid to clean the root canal. For example, a volumetric flow rate can vary between 0.5-50 ml / s, 10-30 ml / s, 1-5 ml / s.

In some embodiments, the velocity of flow 313 passing through root canal 305 may be affected by various parameters, such as the ratio of fluid to air and fluid, the diameter of the root canal (which may vary along portions of the canal root), the viscosity of the fluid, the initial velocity of the fluid in the jet and / or other parameters or combinations thereof. Optionally, the flow rate 313 increases along some portions of the root canal, for example, in a narrow portion. In one example, the flow rate 313 that advances along the root canal wall is 0.5-50 m / s. Optionally, the flow rate 313 changes according to a current location within the root canal. In some embodiments, the flow rate allows a relatively high volume flow rate, eg, 50 ml / s.

Figure 4A illustrates a conical nozzle 401 positioned above the entrance to root canal 403, in accordance with some embodiments of the invention. Figure 4B illustrates an apparatus comprising a conical nozzle 401 and a handle 421, positioned within the access cavity 423 of a tooth above the entrance to the root canal 403. Figure 4C is a geometric representation of a jet of fluid angled 405.

As seen in Figure 4A, at least one stream of angled fluid 405 is discharged from nozzle 401 and directed to inlet 407 of root canal 403.

In some embodiments, for example, as will be described later in Figure 7, nozzle 401 includes one or more conical structures. Optionally, nozzle 401 includes an internal cone 411 positioned within an external cone 413. In some embodiments, the flow of fluid in a lumen between cones 411 and 413 creates the angled direction of fluid jet 405 or a plurality of jets of fluid.

In some embodiments, the angled direction of fluid jet 405 or a plurality of fluid jets is obtained by the conical structure of nozzle 401. In one exemplary embodiment, fluid 415 flows into inner cone 411, passes (through For example, through an inclined tube (as will be shown later) to the outer cone 413, and circulates within a narrow lumen 417 between the outer cone 413 and the inner cone 411, until reaching the outlet opening 419 of the nozzle 401. In some embodiments, the speed of the fluid increases and / or decreases as it circulates in the light, for example, by changing the radius of the flow path.

In some embodiments, the nozzle 401 and / or the outlet opening 419 of the nozzle 401 are positioned above the inlet 407 to the root canal 403, for example 1mm, 7mm, 1cm and / or intermediate distances or more high above. In some embodiments, outlet opening 419 is positioned vertically above inlet 407 such that a vertical axis passes along a central longitudinal axis of nozzle 401 and root canal 403. A potential advantage includes irrigating the root canal 403 with one or more angled fluid jets 405 while nozzle 401 is positioned directly over inlet 407 of root canal 403. In some embodiments, nozzle 401 is angled with respect to the vertical axis y.

In some embodiments, an angle jet diameter 405 is less than a diameter 423 of outlet opening 419. For example, if a diameter of outlet opening 419 is 0.8 mm, a diameter of fluid jet 405 For example, when passing through outlet opening 419 it may be 10 pm, 90 pm, 0.5 mm, 0.1 mm, 0.3 mm, and / or intermediate or smaller diameters. In some embodiments, the diameter of the angled stream 405 changes as it flows between outlet opening 419 and inlet 407 into the root canal.

In some embodiments, when using a plurality of angled jets 405, a distance between any pair of angled jets exiting through outlet opening 419 varies between 0.01-3mm, such as 0.05mm, 0.8mm, 2mm. Optionally, this distance affects the formation of a coating similar to the fluid flow that advances along the root canal wall 421, for example, as described above.

In some embodiments, when fluid 415 circulates within lumen 417, a direction and / or magnitude of its momentum is determined by the structure of nozzle 401.

In some embodiments, one or more parameters are selected (by a dentist and / or manufacturer) to create the designated flow of fluid along the wall of the root canal for soft tissue removal. In some embodiments, these parameters include: the number of angled fluid jets, the pressure of the angled fluid jets, the speed of the jets, the diameter of the jets, the viscosity of the fluid, the ratio of gas to liquid , the amount of abrasive powder added to the fluid, the duration of the treatment, the positioning of the nozzle, and / or any other parameter or combination of them. In one example, the speed and pressure of the fluid jet can be selected so that once the jet hits a wall at the root canal inlet, the fluid does not spray past the root canal inlet, for example, in the direction of the tooth crown. In some embodiments, the parameters may depend on each other, for example, the ratio of gas to liquid and / or may affect the viscosity of the fluid.

In some embodiments, as seen in Figure 4B, an access cavity 423, as mentioned above, is created through the crown 425 of the tooth. Optionally, access cavity 423 passes through layers of dentin and enamel tissue. In some embodiments, access cavity 423 exposes pulp chamber 427. In some embodiments, pulp chamber 427 is cleaned using the described system and / or method. Optionally, the pulp chamber is cleaned by other means. In some embodiments, the described system and / or method is used to clean and / or erode any other part of the tooth, but may have special advantages when used to treat a root canal.

In some embodiments, at least a portion of the nozzle 401 passes through the access cavity 423. In some embodiments, at least a portion of the nozzle 401 is inserted through the pulp chamber 427. In some embodiments, at least a portion of the nozzle 401, for example, the tip including the outlet opening 419, is narrow enough to enter at least a portion of the internal lumen of root canal 403.

In some embodiments, the nozzle 401 is connected to a handle 421. In some embodiments, an inlet pipe passes through the handle 421 and connects to the nozzle 401, as will be explained later. In some embodiments, handle 421 is used to drive nozzle 401.

FIG. 4C is a geometric representation of angled stream 405. In the described figure, angled stream 405 exits a nozzle at point A and strikes the wall of the root canal at point B. In some embodiments, point B It is located on a circumference of the root canal entrance. Alternatively, point B is below the circumference of the root canal inlet, for example 0.1mm, 1mm, 3mm and / or intermediate distances below.

As shown in this figure, the x-axis extends along a diameter of the root canal, perpendicular to the root canal wall. As mentioned herein, the y-axis is a vertical axis that runs longitudinally, for example, parallel to the root canal wall. The z axis is perpendicular to both the x and y axes. Line A'B is a projection of the jet at an angle 405 in the xz plane. In some embodiments, an angle a between the angled jet 405 (line AB) and the xz plane is an acute angle, for example, an angle between 10-85 °. In some embodiments, an angle p between the projection A'B of the jet at angle AB and the tangential axis z is an acute angle, for example, an angle less than 90 °, such as 20 °, 50 °, 70 °. In some embodiments, the size of angle p affects the flow path. A potential advantage of an acute angle p, eg, between 5-10 °, 15-20 °, includes creating a more efficient flow path, in which the flow passes closely along the duct wall. Optionally, the size of angle p can affect the radii of the helical flow through the root canal. In some embodiments, the angle p can be selected to promote adhesion of the flow to the wall and / or reduce rebound.

In some embodiments, an angle jet velocity vector V 405 (line AB) can be described by its three velocity components along the axis, shown in this figure as Vx (along the x axis), Vy (a along the y axis) and Vz (along the z axis). In one example, the velocity component Vy can be 2-50 m / s, and the velocity component Vz can be 0.5-25 m / s.

In some embodiments, additionally and / or alternatively to angle jets, an axial jet (eg, extending parallel to the vertical axis y) may be used.

In some embodiments, any of the ideas and / or methods described above or their combinations can be implemented in the embodiments described below and / or any other embodiment of the invention.

Figure 5 shows a side view of various contours of an angled fluid jet beam 501 (not shown in this figure), in accordance with some embodiments of the invention. The beam contours shown in this figure describe beams leaving a nozzle 503, which have not yet entered a root canal.

In some embodiments, as described above, a beam of a plurality of angled fluid jets is discharged from the nozzle 503. In some embodiments, the structure of the nozzle affects the shape of the beam. In some embodiments, the size and / or shape of the nozzle tip affects the shape of the beam. For example, an elongated tip, as will be shown later, can be used to create a narrower, focused beam from angled jets. Alternatively, a shorter tip can be used to create a more scattered beam of angled jets.

In some embodiments, a beam diameter 505 extends beyond a diameter 507 of the nozzle outlet opening. In some embodiments, as shown in this figure, a beam diameter changes, for example, it increases as flow progresses toward the root canal entrance. Optionally, this scheme is created due to jets at opposite angles (eg, jets coming out of opposite ends of a nozzle diameter). In some embodiments, for example, as shown in this figure, several beams may have different diameters at a certain axial distance from the nozzle outlet opening. For example, diameter 505 is shorter than diameter 509.

In some embodiments, for example, when a nozzle outlet opening is placed within a root canal lumen, the beam jets can immediately impact the root canal wall, which can channel fluid to a helical flow to the along the wall.

In some embodiments, the designated flow along the root canal wall is the result of the original direction in which the angled jets exit the nozzle, and / or the result of the angle created when the jets hit the root canal .

In some embodiments, at least some of the angled jets flow in the same direction.

In some embodiments, a relationship between air and liquid affects the shape of the beam. Optionally, the density of the fluid affects the shape of the beam.

In some embodiments, the beam outline may have other shapes, such as a bottleneck shape, a cylindrical shape, a bell shape, and / or any other shape.

Figure 6A is a cross sectional view of an embodiment of an apparatus comprising a handle 601 and a nozzle 603, for cleaning and / or eroding a root canal with one or more angled fluid jets. Figure 6B is a schematic of the apparatus comprising the handle and the nozzle.

In some embodiments, handle 601 comprises one or more pipes 605, optionally passing longitudinally along an internal lumen of the handle.

In some embodiments, tubing 605 terminates at its distal end at an inlet opening to nozzle 603, for example, an inlet opening leading to an internal cone of the nozzle, as will be described later.

In some embodiments, a proximal end 607 of handle 601 is configured for manual grasping by the user.

In some embodiments, a distal end 609 of handle 601 connected to nozzle 603 is configured for insertion into a tooth, for example, through a pulp chamber, to allow placement of a nozzle outlet opening 603 above of a root canal entrance as previously described. Optionally, handle 601 comprises a taper portion near nozzle 603 (not shown in this figure), which can facilitate insertion of distal end 609 through, for example, an access cavity created in a tooth. In some embodiments, the height of the nozzle is small enough to allow its insertion into the mouth, which for example varies between 5-15 mm.

In some embodiments, inner tubing 605 extends beyond proximal end 607 of handle 601. Optionally, liquid passes through inner tubing 605, for example, by being connected at the proximal end to a liquid tank. Optionally, air passes through internal tubing 605, for example, by being connected at the proximal end to an air compressor. In some embodiments, the fluid comprising air and liquid passes through line 605. In some embodiments, two lines are used, one to pass liquid and the other to pass air. In some embodiments, air and abrasive powder (for example, transferred from an abrasive powder tank) pass together through at least one of the pipes. In some embodiments, one pipe may be surrounded by another pipe (co-piped) so that the internal pipe is used, for example, to transfer liquid, and the external pipe is used, for example, to transfer air. In some embodiments, air, liquid, abrasive powder, and / or combinations thereof pass through at least one of the pipes through the handle.

In some embodiments, the pipes can be connected, for example, at the proximal end 607 of the handle 601, to create the air and liquid fluid which then circulates within the nozzle 603 until it is discharged in the form of angled jets.

In some embodiments, the nozzle 603 has a conical structure, for example, as will be explained in the following figure. In some embodiments, the nozzle 603 comprises an inner cone 613 positioned within an outer cone 615. In some embodiments, an inclined tube 617 is used to pass fluid from the inner cone 613 into a lumen between the two cones, for example, as It will be explained in the following figure.

In some embodiments, nozzle 603 comprises an additional cone 611, for example, used to suck fluid back up through the root canal, for example, as will be explained later in Figure 10. In some embodiments, the fluid Aspirated can pass through the handle, for example, passing in a direction opposite to air and / or liquid past the nozzle 603. Optionally, the aspirated fluid passes through one or more pipes in the handle. Optionally, the proximal end 607 of handle 601 is connected to a pipe and / or tank and / or any other element used to discard the aspirated fluid.

In some embodiments, the nozzle and / or any component thereof and / or the handle may be made of various materials, such as, for example, one or more stainless steel, titanium, aluminum, anodized coated aluminum, PPM, plastic or other biocompatible and / or sterilizable materials and / or combination of materials. In some embodiments, at least a portion of the mouthpiece and / or handle is disposable. In an exemplary embodiment of the invention, the nozzle is formed of rigid materials and / or geometries, however, a tip thereof can be made flexible.

In some embodiments, the nozzle can be manufactured and / or used separately from the handle and / or the rest of the system, described below.

In some embodiments, the handle may comprise controls such as the on / off button to control the duration of the treatment, a dial to control the ratio between air and liquid, etc.

Figure 7A is a cross sectional view of a conical nozzle 701, and Figure 7B is a side view of an internal cone 703 configured within conical nozzle 701, in accordance with some embodiments of the invention.

In some embodiments, the nozzle 701 comprises an inner cone 703 positioned within an outer cone 705. In some embodiments, the inner cone 703 and the outer cone 705 are connected by a tube, eg, a tube or inclined conduit 707 that is it extends between an inner lumen of the inner cone 703 and a lumen 709 between an outer face of the inner cone 703 and an inner face of the outer cone 705.

In some embodiments, the outer cone 705 has a cylindrical upper portion 711. In some embodiments, the outer cone 705 has a recess 713, for example configured along one face, the cylindrical upper portion 711, optionally, in continuity with a one-handle tubing as described above, to allow fluid to enter the inner cone 703. In some embodiments, the recess may be circular, triangular, rectangular, or any shape that allows fluid flow through the inner cone 703. Optionally, the size and / or shape of the recess is determined according to the size and / or shape of an inlet opening 719 to the inner cone 703.

In some embodiments, the outer cone 705 has an outlet opening 715, which can be placed above the inlet to a root canal. In some embodiments, the outlet opening may be circular, for example, with a diameter 717 ranging from 0.3-2 mm. Optionally, the diameter of the outlet opening is determined as needed, for example, according to a diameter of the root canal inlet.

In some embodiments, the outer cone 705 comprises a needle-shaped narrow tip portion 737. In some embodiments, the length of the needle-shaped narrow tip portion 737 varies between 0.2-7 mm. In some embodiments, the narrow tip 737 (comprising the outlet opening 715) is inserted into a root canal lumen. Optionally, the narrow tip portion is inserted at a distance of 0.2mm, 0.5mm, 1mm, 2.5mm and / or any intermediate or higher distance measured longitudinally from the root canal entrance. In some embodiments, an outer diameter of the tip portion 737 varies between 0.5-2.5mm and an inner diameter (optionally the diameter of the outlet opening, as mentioned above) varies between 0.3-2 mm. In some embodiments, the diameter of tip portion 737 is small enough to allow insertion of tip portion 737 into at least a portion of the root canal. Optionally, the tip portion 737 is flexible, for example made of flexible material.

In some embodiments, the cylindrical top 711 is covered by a cover cap 721, for example, to prevent fluid from escaping through the top of the nozzle 701.

In some embodiments, the cover cap 721 can be screwed onto the top of the cylindrical top portion 711.

In some embodiments, the inner cone 703 comprises a cylindrical upper portion 723, which can be dimensioned and / or shaped according to the cylindrical upper portion 711 of the outer cone 705.

In some embodiments, the inner cone 703 comprises an inlet opening 719, for example configured along one face of the cylindrical upper portion 723. In some embodiments, the inlet opening 719 is configured in continuity with the recess 713 of the cone External 705. In some embodiments, the inlet opening may be circular, triangular, rectangular, or any shape that allows fluid flow through.

In some embodiments, the cylindrical upper portion 723 fits within the cylindrical upper portion 711 so that no space is formed between them, for example, preventing fluid from flowing between the two upper cone portions. In some embodiments, a diameter of the cylindrical upper part 723 is only slightly smaller than a diameter of the cylindrical upper part 711. For example, a diameter of the cylindrical upper portion 723 varies between 2-18 mm and a diameter of the portion cylindrical upper 711 varies between 3-20 mm.

In some embodiments, an upper portion 725 of the cylindrical upper portion 723 is open. In some embodiments, if the cylindrical portion 723 of the inner cone 703 extends to the same height as the cylindrical portion 711, the cover cap 721 can cover the inner and outer cones.

In some embodiments, a tip 727 of inner cone 703 is closed, to prevent fluid from passing. In some embodiments, tip 727 extends to outlet opening 715, and / or extends beyond outlet opening 715, eg, 1 mm beyond.

In some embodiments, an inclined tube 707 extends between an inner lumen of the inner cone 703 and a lumen 709 between an outer face of the inner cone 703 and an inner face of the outer cone 705. Optionally, inlet 729 to the tilted tube 707 serves as the outlet opening for the fluid exiting the inner cone 703. Optionally, the outlet 731 of the inclined tube 707 is configured at the lowest point along a face of the cylindrical upper portion 723, so that it conducts light 709.

In some embodiments, the size of the lumen 709 is determined by a difference in the diameters of the tapering portions 733 and 735 of the outer cone 705 and the inner cone 703, respectively. For example, an initial diameter of the tapering portion 733 is 3 mm and an initial diameter of the tapering portion 735 is 0.3 mm. In some embodiments, a distance between the inner and outer cones that form the light 709 is constant, for example, a distance of 1mm. In some embodiments, a distance between the inner and outer cone changes, for example, increases along a vertical axis.

In some embodiments, a fluid, optionally, including abrasive liquid, air, and / or powder or combinations thereof, flows through recess 713 of outer cone 705, into inlet opening 719 of inner cone 703, and into a lumen. of the inner cone 703. In some embodiments, as the fluid builds up inside the inner cone 703, the pressure can increase and the fluid can be forced through inlet 729 to the down tube 707. Once the fluid leaves the Inclined tube 707 through outlet 731, fluid circulates within lumen 709 between the inner and outer cones. Optionally, the circulation is helical. Optionally, as the light narrows, the speed of the fluid flow increases. In some embodiments, helical circulation causes fluid to exit nozzle 701 through outlet opening 715 of outer cone 705 in the form of one or more angled fluid jets as described above.

In some embodiments, due to the ratio of air to liquid, eg, 90% air and 10% liquid, the fluid entering light 709 is an aerosol. A potential advantage of the aerosol includes the reduction of friction created between the surface of the cones and the fluid, which can optionally allow for a higher velocity of the fluid (aerosol).

In some embodiments, either cone can be non-symmetric and / or distorted.

Figures 8A and 8B are schematic diagrams of example systems for treating a root canal, in accordance with some embodiments of the invention.

In some embodiments, the system comprises a liquid tank 801, for example, for storing liquids such as water, disinfectant, and / or medications. Optionally, more than one liquid tank is used, for example, to store drugs separate from water, or separate drug disinfectants. In some embodiments, the capacity of the liquid tank varies between 0.2-50 l. In some embodiments, the liquid tank can be made of aluminum, steel, plastic, or any material capable of holding the liquid and withstanding air pressure. In some embodiments, the liquid tank 801 may comprise a mixing element, such as a mechanical, hydraulic, or electrical rotating element for continuous mixing of the liquid.

In some embodiments, the liquid tank 801 is connected to an air compressor 803. In some embodiments, the air compressor pushes air into the liquid tank 801. In some embodiments, the pressure created by the air compressor ranges from 5 -500 PSI, 1-100 PSI, 100-200 PSI. Optionally, as the air compressor pushes air into the liquid tank, the pressure builds up inside the tank and the liquid is forced through a tank outlet opening. In some embodiments, the tank outlet opening is connected to a handle 805 of an apparatus as described above, eg, connected by a pipe.

In some embodiments, the system comprises a collection tank 809. Optionally, the collection tank 809 is used for the return fluid leaving the root canal, which may comprise an organic substance, a non-organic substance and / or debris. In some embodiments, collection tank 809 is connected to an 811 pump and / or a vent connector. In some embodiments, the pump is used to suck the return fluid, for example, through a suction cone of a nozzle (not shown in this figure), through handle 805, and through one or more pipes. leading to collection tank 809. Optionally, a suction cap can be placed on the tooth and / or inside the mouth to collect return fluid, saliva and / or debris.

In some embodiments, as shown in Figure 8B, a dust container 813 is used to store the abrasive powder. In some embodiments, the powder tank 813 is connected to the air compressor 803.

Air, liquid, abrasive dust and / or any combination of them can pass through one or more pipes in the system.

In some embodiments, as shown in Figure 8A, a pipeline connected to the air compressor 803 and a pipeline connected to the liquid tank 801 are joined at any point along a path leading to the handle 805, so that the air and liquid are mixed before entering handle 805. In some embodiments, as shown in Figure 8B, a plurality of pipes can conduct air, liquid, abrasive powder and air, liquid and air and / or any combination thereof in the 805 handle. In some embodiments, liquid and air or any other combination may flow through co-centered pipes.

In some embodiments, a pipe includes micropores, for example, allowing air to flow inward but preventing liquid from leaving the pipe.

In some embodiments, any of the components and / or combinations thereof described above are passed separately and mixed only in the nozzle lumen (not shown in this figure).

In some embodiments, a control panel 815 is used, for example, to control the passage of air, liquid and / or dust abrasive. In some embodiments, the pressure, speed, volume, flow rate and / or any other parameter can be controlled. In some embodiments, the duration of treatment is controlled using control panel 815. In some embodiment, control panel 815 may be connected to a power source 817.

In some embodiments, two or more system components, such as the liquid tank, air compressor, pump, and / or any other component, are connected by an electrical circuit 819. In some embodiments, control panel 815 is used to activate the 819 electrical circuit to control the operation of one or more system components. For example, an electrical signal can be sent using control panel 815 to activate air compressor 803, to release liquid from liquid tank 801, to pass fluid to the handle, to open a valve along a pipe or joint, and / or any other function of the system.

Figures 9A-9D illustrate an embodiment of a conical nozzle 901 comprising a pipe 903, which extends between the handle 905 and the outlet opening 907 of the nozzle 901.

Figures 9A and 9B illustrate two embodiments including line 903. Figure 9B shows conical nozzle 901 having a narrow tip portion 911 as described above. Figure 9A is a conical nozzle 901 having the flat tip portion 913. Figure 9C is a cross section of a nozzle similar to that described in the previous figures that further includes pipe 903. Figure 9D is a side view of an internal cone of that nozzle.

In some embodiments, the longitudinal pipe 903 is used to pass air, abrasive powder, liquid, and / or a combination thereof through the nozzle 901. In some embodiments, the flow is through the pipe 903 parallel to a fluid flowing through a main path of the nozzle 901, as described above.

In some embodiments, a distal portion of tubing 903 protrudes from outlet opening 907. In some embodiments, for example, as shown in FIG. 9B, if the narrow tip portion 911 is inserted into at least a portion of the root canal, 903 tubing can be used to deliver any of the above materials to a location within the root canal.

In some embodiments, tubing 903 affects the direction of the discharged angled fluid jets by deflecting them.

In some embodiments, a proximal end of line 903 is connected to any of the system components described above, such as the fluid tank, air compressor, powder tank, and / or any of the lines.

In some embodiments, the internal and external cones that comprise the nozzle 901 include an opening 915 for the passage of the pipe 903, for example configured along one face of the upper cylindrical portion of both cones, such as above or below of a recess 917 and an inlet opening 919 of the outer and inner cones respectively.

In some embodiments, as shown in Figures 9C and 9D, line 903 passes through a flat tube parallel to inclined tube 909. In some embodiments, line 903 intersects tube 909, for example, to allow mixing. of fluid with substance passing through line 903.

Figure 10A illustrates a nozzle comprising a suction cone 1001, as mentioned above, and Figure 10B illustrates a horizontal cross section of the nozzle.

In some embodiments, the suction cone 1001 is shaped and / or dimensioned according to an external cone and / or an internal nozzle cone.

In some embodiments, the suction cone 1001 is mounted externally to the nozzle. In some embodiments, the suction cone is attached to the nozzle during a molding process. In some embodiments, other mechanical means, such as pins or screws, are used to secure the suction cone.

Optionally, a lumen 1011 is formed between the tapering portions of the suction cone 1001 and an external cone 1013 of the nozzle. In some embodiments, this light comprises conduits or tubes.

In some embodiments, the distal tip of the nozzle 1015 protrudes from the suction cone 1001.

In some embodiments, the suction cone 1001 has one or more outlet openings 1005 and / or 1007. Optionally, the outlet openings 1005 and / or 1007 are configured along a cylindrical top portion 1009 of the suction cone 1001. In some embodiments, outlet openings 1005 and / or 1007 are optionally connected to the handle via pipes. In some embodiments, the pipes are connected to a pump, such as a vacuum pump to draw the return fluid up through the nozzle and through the handle to discard it, as previously described in figure 8.

In some embodiments, the aspirated fluid can pass through the suction cone 1001 in a lumen between an internal face of the suction cone and an external face of the external nozzle cone. In some embodiments, if the light comprises ducts or tubes, the fluid can be sucked directly through the tubes.

In some embodiments, the fluid returning upward through the root canal may contain the removed organic and / or inorganic substances, such as pulp tissue, nerve tissue, blood vessels, abrasive dust, and / or other debris removed by flow.

In some embodiments, the suction cone 1001 is covered by a cap, which is optionally screwed onto the top of a cap of the outer nozzle cone to prevent fluid from escaping through the top of the suction cone 1001.

Figure 10B shows a horizontal cross section of the nozzle along line AA. A central circular light 1017 is the light formed between the inner and outer cones. The three arched lights 1019 are the lights formed between the outer cone and the suction cone 1001. In some embodiments, a space 1021 between arched lights includes anchors for attaching the suction cone 1001 to the taper portion of the nozzle.

Figures 11A-B show two embodiments of a nozzle including one or more steering lines to create one or more angled fluid jets, in accordance with some embodiments of the invention. Figure 11A includes a nozzle 1101, a horizontal cross section of the distal end of the nozzle 1105, and a longitudinal cross section of the nozzle 1107. Figure 11B includes a conical nozzle 1101, a horizontal cross section 1109 of the distal tip of the nozzle (outlet opening) and a horizontal cross section 1111 of the proximal tip of the nozzle.

In some embodiments, a nozzle 1101 of an apparatus may comprise one or more conduits for directing the fluid jets at an angle. In some embodiments, the conduits are formed as tubes 1103. In some embodiments, the nozzle 1101 is a cylinder. In some embodiments, tubes 1103 are configured along the inner wall of nozzle 1101.

In some embodiments, an angle of the tube is determined according to an angle resulting from the jet of fluid formed by the tube. In some embodiments, the configuration (such as the angle) of the tube is adjustable, for example, by connecting a back plate of a tube using a screw to the wall of the nozzle 1101.

In some embodiments, tubes 1103 have a similar diameter. In some embodiments, tubes 1103 have various diameters. In some embodiments, a single tube can change diameter.

Figures 12A-12C are drawings of a nozzle comprising at least one valve to control flow through the nozzle, in accordance with some embodiments of the invention. In Figure 12A, the nozzle has a conical contour 1219, and in Figure 12B, the nozzle has an elliptical contour 1221. In both Figures 12A and 12B, the nozzle is formed as a single piece, eg formed using molding methods. In Figure 12C, the nozzle can be made up of separate components, for example, cones connected to each other, as will be explained later.

In some embodiments, a valve 1201 is used to control the flow, eg, the flow of air (or any other gas), liquid, abrasive powder, and / or combinations thereof in the nozzle. In some embodiments, as shown in Figures 12A and 12B, valve 1201 is placed between the end of a pipe 1203 passing through the handle, and the lumen 1205 formed between an external and internal cone of the apparatus. In some embodiments, as shown in FIG. 12C, valve 1201 is placed between the end of pipe 1203 and a connecting lumen 1217. Optionally, when the valve is in the open position, a flow of any of the above substances and / or combinations thereof enters connection light 1217, from which it then passes to light 1205. Additionally and / or alternatively, at least one valve can be placed between connection light 1217 and light 1205. Additionally and / or alternatively, a valve is placed at any junction, inlet opening, outlet opening, along a pipe, a nozzle pipe, or any other portion of the nozzle.

In some embodiments, valve 1201 comprises a sealing element 1207. In some embodiments, the sealing element prevents fluid and / or any other substance from flowing upward in line 1203.

In some embodiments, valve 1201 comprises a spring 1209. In some embodiments, the spring extends or compresses due to pressure of the air and / or liquid. In some embodiments, spring 1209 and / or sealing member 1207 is controlled using other means, such as mechanical means (eg, connecting valve 1201 to a lever controlled from the handle), hydraulic means (actuated, eg, by the pressure of the fluid that passes through) and / or electrical means.

In some embodiments, when the spring 1209 is extended, it pulls the sealing member 1207 into an open position.

Optionally, in the open position, a material such as air, liquid, abrasive powder, and / or combinations thereof can flow into light 1205.

Additionally and / or alternatively, a valve 1211 is used to control the flow of fluid from one lumen of the inner cone to lumen 1205 between the outer and inner cones. Optionally, the valve sealing member 1213 is positioned at the end of the inclined tube 1215. In some embodiments, this valve is used to control the duration of treatment, for example, periodically pushing the valve into a closed position.

In some embodiments, other elements such as a bead can be used in place of a spring. In some embodiments, only the sealing element 1207 can be used, for example, formed as a flap that opens due to air pressure.

A potential advantage of using valve 1201 or the like includes the ability to add any substance to the fluid immediately before the fluid enters the root canal. In one example, fluid-dissolvable abrasive powder, such as salt, can pass (with or without air) through line 1203 and enter lumen 1205. Optionally, since the addition of salt to the liquid is performed In a relatively short time before it is introduced into the root canal, a portion of the salt does not dissolve and can be used as an abrasive powder to remove soft tissue from the root canal.

Figures 13A-13D illustrate a nozzle comprising a cone 1301 with a pin-shaped element 1303 occupying at least a portion of the internal lumen of cone 1301, in accordance with some embodiments of the invention. Figure 13B is a horizontal cross section along the line AA of the nozzle. Figure 13C shows an enlarged view of the pin-shaped element 1303.

In some embodiments, a distal end of tube 1305 passes into a lumen 1307 in cone 1301 that is not occupied by pin-shaped element 1303. In some embodiments, other elements, eg, a cylinder, may be used to occupy a portion of the nozzle, to create a light that can be used to flow fluid in a specific flow pattern and / or direction.

In some embodiments, the pin-shaped element 1303 has a diameter less than the diameter of the cone 1301. In some embodiments, the fluid passes into the lumen 1307. In some embodiments, a distance between one face of the rod portion 1309 of the pin-shaped element 1303 and an internal face of the cone 1303 varies between 0.2-3 mm.

In some embodiments, as seen in FIG. 13A, rod portion 1309 is cylinder-shaped comprising a rounded elliptical tip 1315. In some embodiments, as seen in FIG. 13D, rod portion 1309 is cone shaped narrowing, which has a pointed tip 1317.

In some embodiments, a head 1311 of the pin-shaped element 1303 fits within cone 1301 such that an upper portion of cone 1301 is completely occupied by head 1311. Optionally, this prevents fluid from passing.

In some embodiments, tube 1305 may be connected at its proximal end to a tube in the handle (not shown in this figure). In some embodiments, fluid such as liquid, air, and / or abrasive powder or combinations thereof can pass through tube 1305. In some embodiments, fluid circulates within lumen 1307, for example, in a helical flow. Optionally, helical flow is caused by rod portion 1309, as fluid is forced to pass around it. In some embodiments, fluid exits the nozzle through angled jet outlet 1313 due to helical flow.

In some embodiments, tube 1305 has an elliptical cross section 1319. Alternatively, tube 1305 has a circular cross section, a rectangular cross section, or any other shape. In some embodiments, tube 1305 rotates around rod 1309, for example, adjacent to the rod.

In some embodiments, as seen in 13A, cone 1301 has a narrow elongated tip portion 1315. In some embodiments, as seen in 13D, cone 1301 has a flat tip portion 1317.

Figure 14 shows an example assembly of a nozzle, in accordance with some embodiments of the invention.

In some embodiments, the nozzle comprises an inner cone 1401, an outer cone 1403, a suction cone 1405, and one or more caps 1407. In some embodiments, for example, during manufacturing, the inner cone 1401 is inserted into an outer cone 1403. In some embodiments, the inner cone 1401 is mounted inside the outer cone 1403, and optionally both cones are mounted inside the suction cone 1405.

In some embodiments, at least two of the cones are connected by mechanical means, such as pins or screws. In some embodiments, the cones are connected by molding means, for example, by melting at least two of the cones together using a designated mold. Optionally, two and / or all cones are molded together, for example, creating a mouthpiece made from one piece.

In some embodiments, either cone is removable, for example, to allow cleaning.

Figure 15 is an illustration of a nozzle including shaping elements of the outflow to create one or more angled fluid jets. In some embodiments, the outflow shaping elements may be wing shaped 1505.

In some embodiments, nozzle 1503 includes one or more wing elements 1505. In some embodiments, wing elements 1505 are used to deflect fluid outlet nozzle 1503 to create one or more angled jets, for example, as previously described.

In some embodiments, the fluid passes in a parallel flow through the cylindrical nozzle 1503, and the wing members 1505 deflect the parallel fluid in an angled direction. In some embodiments, nozzle 1503 comprises parallel tubes, and wing members 1505 are placed at a distal end of the tubes.

In some embodiments, the wing members 1505 are configured along an outlet opening of the nozzle 1503.

The terms "comprise", "comprising", "includes", "including", "having" and their conjugates mean "including, but not limited to".

The expression "consisting of" means "that includes and is limited to".

The term "consisting essentially of" means that the composition, method or structure may include additional ingredients, steps and / or parts, but only if the additional ingredients, steps and / or parts do not materially alter the basic and novel characteristics of the claimed composition, method or structure.

As used herein, the singular form "a", "one" and "the" include references to plurals unless the context clearly indicates otherwise. For example, the term "a compound" or "at least one compound" can include a plurality of compounds, including mixtures thereof.

Throughout the present application, various embodiments of this invention may be presented in a range format. It should be understood that the description in range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Therefore, the description of an interval should be considered to specifically disclose all possible secondary intervals, as well as the individual numerical values within that interval. For example, the description of an interval, such as 1 to 6, should be considered to have specifically disclosed secondary intervals, such as 1 to 3, 1 to 4, 1 to 5, 2 to 4, 2 to 6, 3 to 6, etc., as well as the individual numbers within that range, eg 1, 2, 3, 4, 5, and 6. This applies regardless of the width of the range.

As long as a numerical range is indicated herein, it is intended to include any quoted number (fractional or integer) within the indicated range. The terms "which varies / varies between" a first indicated number and a second indicated number and "which varies / varies from" a first indicated number "to" a second indicated number are used interchangeably herein and are intended to include the first and second numbers indicated and all fractional and integer numbers between them.

As used herein, the term "method" refers to the ways, means, techniques, and procedures for carrying out a given task, including, but not limited to, such ways, means, techniques, and procedures that they are easily known or developed from the ways, means, techniques and procedures of professionals in the chemical, pharmacological, biological, biochemical and medical techniques.

As used herein, the term "treating" includes reversing, substantially inhibiting, slowing down, or reversing the progression of a condition, substantially improving the clinical or aesthetic symptoms of a condition, or substantially preventing the onset of clinical or cosmetic symptoms of a condition.

It is appreciated that certain features of the invention, which are, to be clearer, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features of the invention, which are, to summarize, described in the context of a single embodiment, may also be provided separately or in any suitable secondary combination or as suitable in any other described embodiment of the invention. Certain features described in the context of the various embodiments should not be considered essential features of those embodiments, unless the embodiment is rendered inoperative without those elements.

Various embodiments and aspects of the present invention, as defined above and as claimed, later, in the claims section, find experimental support in the following examples.

Examples

Reference is now made to the following examples, which together with the foregoing descriptions illustrate some embodiments of the invention in a non-limiting manner.

An experiment to test the feasibility of an apparatus and method for endodontic treatment using angled fluid jets

The inventors carried out an experiment to test the feasibility of a system comprising an apparatus for cleaning, erosion and / or disinfection of a root canal as previously described.

Experimental design

Forty-one samples of human teeth were extracted from patients. The specimens included a group of molars that had 2-4 root canals, and a group of incisors that had a single root canal. In total, 182 root canals were tested in the experiment. Each tooth sample had one or more types of root canals, as indicated below.

5 types of root canals were tested: a standard root canal (53 samples), a curved root canal (40 samples), a curved and pointed root canal (32 samples), a root canal with an enlarged opening at the apex, which varied between 2-3 mm, which was created naturally as a result of calcification (33 samples) and samples with an extremely narrow root canal (24).

Samples of 11 teeth that had 2-3 root canals were extremely narrow, having an inlet opening less than 0.5 mm in diameter.

Immediately after extraction, the samples were placed in a 10% bleaching solution, containing 10% chlorine and 90% water, (other solutions may also be used), to prevent dehydration of the root canals.

The following procedure was performed for each sample. Initially, an access cavity was drilled through the crown of the tooth to allow access through the pulp chamber to the root canal. An entrance to the root canal was exposed and the sample was placed back into the bleaching solution. The sample was removed from the solution and placed in a rubber mold. In this phase, an image of the sample was taken using a 320 section CT image acquisition device. Optionally, other imaging devices can be used.

An apparatus and system, for example, as described in Figure 8 above, were used for cleaning, abrasion, and disinfection of each of the samples. A nozzle of the apparatus was inserted through the pulp chamber and positioned such that a nozzle outlet opening was configured vertically above the entrance to a root canal, at a distance of approximately 1-3 mm.

The fluid used to treat the root canals contained water, air, and glass powder (used as an abrasive powder). The pressures used were a water pressure of 80 PSI and an air pressure of 80 PSI. Fluid passed through the system line, for example through lines in the handle of the apparatus, reaching the nozzle and exiting through the outlet opening as angled jets of fluid, as described above.

The cleaning, abrasion and disinfection of the root canal of each sample was achieved by the flow of liquid that advances along the wall of the root canal, removing organic substances such as nervous tissue, pulp tissue and / or residues, as has been previously described.

The duration of treatment for each of the samples was determined according to parameters such as the existence of a narrow portion, the existence of curvature, the length of the root canal and / or other parameters or combinations thereof. The duration of treatment used in this experiment was 15 seconds (applied to 13 samples), 30 seconds (applied to 15 samples) and 45 seconds (applied to 13 samples). Optionally, other durations can be used.

Image acquisition of each sample using a 320-section CT image acquisition device was performed again at the end of the process.

Each sample was tested for apex penetration (referred to in this example as further expansion of a natural, normal apex opening), degree of apex penetration (if any), penetration along the canal wall, and thickness of the eroded layer.

To test that the root canals of the sample are clean, a scanning electron microscope image of each sample was obtained, as will be explained later.

Data analysis and results

Figure 16A-B is a table of the results of the experiment. The table shows that in all tested root canals, the apex was not penetrated (i.e. an initial natural opening did not expand). The table also shows that in all tested root canals, the root canal wall was also not penetrated. The thickness of the removed dentin layer ranged from 100-200 pm for all tested root canals.

Figure 17 shows an image of the dentin layer and dentinal tubules from one of the samples, taken at the end of the experiment described above. This image was taken by a scanning electron microscope, using a magnification of x5000.

Before acquiring the image, the sample was stored in the bleaching solution. Once the sample was removed from the solution, it was sectioned along a longitudinal cross section, to expose the internal lumen of the root canal. This example image shows that the dentin layer 1701 and tubules 1703 have been cleaned and cleared by fluid flow, and do not have a smear layer.

Although the invention has been described in conjunction with its specific embodiments, it is apparent that many alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, it is intended to accommodate all such alternatives, modifications and variations that are within the scope of the appended claims.

Claims (16)

1. An endodontic treatment apparatus comprising a nozzle (401, 603, 701, 901, 1219) comprising a tip small enough to be inserted through the pulp chamber of a tooth; wherein said nozzle is shaped to create a beam comprising at least one jet of fluid at an angle to a vertical axis of said nozzle; and comprising one or more inlet pipes (605) that are configured to be connectable to external sources (801, 803, 813) of components so that a fluid is emitted from the nozzle; characterized in that said nozzle comprises: an inner cone (411, 417, 441, 613, 703) and an outer cone (413, 615, 705) defining a light (709) between them for fluid to flow; wherein said light (417, 709) is configured such that the fluid supplied by said one or more inlet pipes travels through the light (417, 709) along a helical path having a tangential and longitudinal component ; and wherein said angle of said at least one jet of fluid does not intersect said vertical axis of said nozzle. The apparatus according to claim 1, wherein said internal cone comprises an internal light (725) and an inclined connecting passage (617, 707) extends between said light (725) of said internal cone (703) and said light between said inner cone and said outer cone. 3. The apparatus according to claim 1 or claim 2, wherein said nozzle comprises a plurality of ducts to create a plurality of angled jets, the ducts are configured such that the plurality of jets is directed at different angles to that flow together along a root canal wall in a substantially helical pattern. 4. An apparatus according to any one of claims 1-3, wherein said nozzle is shaped such that said beam exits said nozzle as an aerosol. 5. The apparatus according to any of claims 1-4, wherein said apparatus further comprises a suction cone to collect fluid and returning debris, wherein said suction cone has a tip sized to fit within a pulp chamber of a tooth. The apparatus according to any one of claims 1-5, wherein said nozzle comprises one or more outlet flow shaping elements (1505) to create said at least one angled jet. The apparatus according to any one of claims 1-5, wherein the nozzle includes an additional line (903) that extends into the lumen between the internal and external cones of the nozzle that passes fluid flow to through the nozzle parallel to the nozzle axis and positioned so as to deflect the direction of one or more angled jets leaving the nozzle. The apparatus according to claim 7, wherein the additional piping is connectable to one or more external sources of fluid components. 9. The apparatus according to claim 2, wherein the nozzle includes an additional line (903) extending into the lumen between the internal and external cones of the nozzle that passes the fluid flow through the parallel nozzle to the nozzle axis and positioned so as to deflect the direction of one or more angled jets leaving the nozzle; where the pipe also intersects the inclined connection passage. 10. The apparatus according to any one of claims 1-9, wherein the nozzle is characterized by one or more of: a) The internal diameters of the tip and the tip outlet opening are between approximately 0.3 mm and 2 mm. b) an external diameter of the tip varies between approximately 0.5 and approximately 2.5 mm; c) the length of the tip varies between 0.2-7 mm; d) an initial distance from the proximal end of the lumen between the internal and external cones increases distally; e) the width of the lumen between the inner and outer cones is constant or changes distally; f) the distance of the light between the inner and outer cones is 1 mm in its entire length; g) a diameter of an angular jet as it passes through the nozzle outlet opening is in the range of about 10 pm to about 0.3 mm. 11. A system comprising: an apparatus according to any one of claims 1-10; sources (801, 803) of components of said fluid; and a suction source (811) for said suction cone light, wherein said inlet pipes (605) are connected between sources of said fluid components and said nozzle. 12. The system according to claim 11, wherein said fluid component sources comprise sources of a liquid, and at least one of a gas, and an abrasive material. 13. The system according to claim 12, wherein said liquid and at least one of said abrasive material and gas are mixed together in said nozzle. 14. The system according to claim 12 or claim 13, wherein said gas is air, and said fluid comprises between about 10-95% air and between about 10-90 liquid. 15. The system according to any one of claims 12-14, wherein said gas is provided by an air compressor at a pressure ranging from about 5-300 PSI. 16. The system according to any one of claims 12-15, wherein said liquid is provided from a fluid-supplying tank at a volume flow rate ranging from about 0.1-100 ml / second.